Hematocolpos (haematocolpos)

Hematocolpos is a gynaecological condition in which the vagina fills with menstrual blood, often secondary to an imperforate hymen¹. It is often seen in patients who also suffer from Robinow syndrome, double uterus and other congenital conditions.

The condition can become severe in nature as the menstrual blood has no way to escape and may grow to take up the majority of the pelvic cavity (fig, 1), making urination and voiding of bowels difficult¹.

the condition may go unnoticed for some time, with a delayed menarche often

Hematometra is a related condition in which the uterus fills with menstrual blood.

Pathophysiology

The cause of Hematocolpos can vary, but almost exclusively involves physical obstruction of the reproductive tract, leading to a backup of menstrual blood which accumulates proximal to the obstruction.

The majority of cases are the result of an imperforate hymen, which results from abnormalities in the development of the Mullerian ducts³. The condition is also associated with a transverse vaginal septum.

Medical Management

The condition is usually treated surgically with a hymenotomy in the case of an imperforate hymen, or other surgical procedures to remove other obstructive tissues.

As the condition is almost exclusively the result of physical obstruction, surgical management is the only option, with pharmacological interventions aimed at relieving pain and discomfort for the patient.

Clinical Presentation

Patients may present with amenorrhoea or vague abdominal pain².